What is racism like in the NHS? A damning report commissioned by the Health Service identified racial health disparities “at every stage.” . . from birth to death’.
This negatively affected the health of millions of black, Asian and ethnic minority patients, the NHS Race and Health Observatory report concluded last year.
Three weeks ago, the outgoing president of the Royal College of Psychiatrists, Dr Adrian James, warned that racism in the NHS is having a ‘pernicious’ effect on colleagues, ‘who are leaving the NHS in droves’.
And it pains me, as a doctor and member of a family of six who work in the NHS, to say that my family knows exactly what racism in the NHS means, as experienced by our 75-year-old mother, Fauzia Ahsan. her when she was being treated by the London Ambulance Service (LAS) on October 23, 2019.
What happened to our mum was not the first time my brothers and I have seen racism in the NHS – I am an A&E doctor, two of my brothers are GPs, one is a consultant paediatrician, one is a pharmacist and one is a junior doctor .
Our 75-year-old mother, Fauzia Ahsan (pictured), experienced racism when she was treated by the London Ambulance Service (LAS) on October 23, 2019, writes Dr Saleyha Ahsan.
And while the vast majority of people we’ve worked with have been wonderful, caring and dedicated professionals, we’ve faced and witnessed racist behavior, even from a minority of patients (“I don’t want a doctor with a bandana in my head, I want a white doctor’ is something my sisters and I, for example, have heard throughout our careers).
In a particularly harrowing example, my sister, the consultant pediatrician, as a very new young doctor in an obstetrics ward, witnessed a midwife screaming, her hand raised as if to punch a frightened Asian woman and so pregnant she didn’t know what to do. she spoke English and suffered from complications.
Bravely, my sister spoke out about this, and a serious incident investigation was carried out and the midwife was then checked (although she remained in the unit).
So our mom was on the receiving end. She had been admitted to the hospital in October with a urine infection; at that point, a consultant quietly advised us that someone in the family should always stay with my mother.
I understood why he said that: Embarrassingly, older patients without advocates present can be vulnerable in accessing care. And elderly black, Asian, and minority ethnic patients may be even more vulnerable: Last year’s report confirmed what the consultant and I already knew.
So the family arranged for a caretaker to stay with her overnight and we would take turns during the day. Later, her caretaker told us that despite our precautions and her presence, one of the night nurses had treated my mother rudely, calling her a ‘bloody fool’.
Although she was suffering from shortness of breath, when she was offered the chance to go home, my mother took it, wanting not to stay in this environment.
One of my sisters took her home, but when they got there, my mother was struggling.
What happened to our mother was not the first time my siblings and I have seen racism in the NHS, writes Dr Saleyha Ahsan (pictured)
This sister, an experienced GP, called 999 at 7:23pm and described severe shortness of breath, agitation and a recent discharge from hospital after sepsis – all red flags for a call manager or otherwise made, for any health professional.
To the ambulance service’s credit, within nine minutes a team had arrived: a junior paramedic, newly qualified, a year out of his two-year probationary period, and a trainee technician (someone who doesn’t have the same medical training).
By this time, my mother was experiencing severe respiratory problems; The signs are not subtle: As my sister noted in a complaint letter to LAS, our mother was “scared, terrified, gasping, unable to speak properly, her chest wall going up and down rapidly.” clammy, sweaty skin’. Failure to manage this situation can lead to respiratory and cardiac arrest.
Such a patient needs an immediate evaluation, measuring respiratory rate, pulse and oxygen levels, not 20 minutes later, as was the case with my mother. She needed oxygen to be administered through an emergency-specific face mask, instead she received low-dose oxygen through two nasal cannulas.
In medicine we use a scoring system to assess how sick a patient is. The crew underlined the seriousness of my mother’s illness.
In fact, as my GP sister later wrote in her complaint, the team stated in front of her and our mother “that they could have responded to a ‘genuine’ blue light call if they hadn’t had to see mom.”
And yet, as LAS himself later acknowledged, she should have been treated as an emergency, including ‘blue lighting’ to get her to the hospital. ‘We accept that. . . she should have been taken there under emergency conditions,’ she confirmed.
Instead, the trip took around 30 minutes. And one time at A&E, the crew took my mom to a hallway to wait; meanwhile, they were talking to each other and checking their phones while ignoring the deteriorating patient in front of them and my sister’s requests that they alert the nurses because she needed emergency intervention.
The signs my mother was displaying would have alerted anyone, even inexperienced staff, that something was significantly wrong.
It wasn’t just the improper care, it was the lack of kindness that is so upsetting. My mother tried to hold the paramedic’s hand because she was scared. It’s so painful to know that the paramedic shook my mother’s hand and said ‘don’t push me’.
“It hurts me that the EMTs thought it was okay to continually scold her,” my sister, who witnessed the whole thing, wrote to LAS.
Three weeks ago, the outgoing president of the Royal College of Psychiatrists, Dr Adrian James (pictured), warned that racism in the NHS is having a “pernicious” effect on colleagues, “who are leaving the NHS in droves “.
This alternated with laughing at her, this distressed my mother. ‘They were laughing at me, because I couldn’t breathe,’ my mother told me later. The LAS claims that the crew denies it. My mother finally made an appointment at A&E to be seen at 9:10 pm, too long for a patient who is visibly unable to breathe.
I arrived shortly thereafter to find her, clearly distraught and unable to breathe, hanging from the rails of her hospital cart, which was right next to the nurses’ station.
Finally, someone who did care, the night shift registrar, arrived after 10 pm and initiated the correct life-saving emergency treatment. Four days later my mother died.
While what happened to him that day was not the cause of his death, we as a family of medical professionals felt that his treatment had been deeply troubling and unsafe. And it was avoidable.
In the British Army, where I served in the Royal Army Medical Corps, my soldiers were combat medical technicians who worked with the utmost professionalism and care.
I later spent a year in North Wales, working with the Welsh Ambulance Service NHS Trust paramedics, whose work was characterized by kindness, empathy and dedication to their patients. The contrast with caring for my mother could not have been starker.
The tragedy is that while many in the NHS are doing the best they can, too many families across the UK are having similar horrifying experiences of care failure every day, mostly attributed to unprecedented pressures, but some, as our family, are due to racism
What makes our experience not just another failed care story is what the LAS told us: “The team explained that there were several family members on the scene trying to give them information and although they tried to contact Ms. Ahsan Understandably, she preferred to speak to you in her mother tongue.
Now here is the crux of the matter. The only person in my mother’s downstairs bedroom was my sister. (The only other people at home were my father, who is immobile, and my brother was comforting him in the back of the house and did not come out of his room.)
We are not a bilingual family. Never have been. We have many gifts and abilities, but one of them is not linguistics. In fact, we were speaking in our first language: English. Our only language.
My mother was born in Kenya and was a British citizen from birth. She grew up speaking English. Her father was a British government official, awarded an MBE by Queen Elizabeth II. My mother was a retired teacher who taught English at a primary school in London.
My parents had made a conscious decision to make English our only language. It was the only language we spoke to them in (my parents even spoke to each other in English most of the time).
But what if my mother had not spoken English? What if many family members had been present? Does that justify shameful and demeaning care?
LAS CEO Daniel Elkeles has apologized for the distress caused to my family.
“While complaints of this nature are rare, we were eager to learn lessons and have taken a number of steps to ensure a similar situation does not occur again.
“This includes introducing mandatory training for every staff member to address discrimination and promote equality and inclusion, and increase the diversity of our workforce,” he told Good Health.
“We are proud to serve a diverse city and recognize that there is no room for racism in the work we do.”
Having witnessed humiliating acts of dedicated selflessness and professionalism from across the NHS, we understand that sentiment.
But while it may be that complaints about such cases are rare, that does not mean that such behavior is rare: following last year’s NHS report and Dr James’s speech, I now believe that others may have suffered like my mother. In fact, from our experience, others have reached out to our family with their own stories.
Our complaint against LAS is being investigated. Meanwhile, my sister GP, who had worked for NHS 111 and GP Out of Hours in the LAS covered area, has now chosen to work elsewhere in the NHS, finding it too painful.
Instead, the crew was able to continue their work.
